Provider Demographics
NPI:1043287212
Name:GIRSHOVICH, IRINA (MD)
Entity Type:Individual
Prefix:MRS
First Name:IRINA
Middle Name:
Last Name:GIRSHOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ABBOTT BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4151
Mailing Address - Country:US
Mailing Address - Phone:201-886-9699
Mailing Address - Fax:201-886-9015
Practice Address - Street 1:810 ABBOTT BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4151
Practice Address - Country:US
Practice Address - Phone:201-886-9699
Practice Address - Fax:201-886-9015
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ809153Medicare ID - Type Unspecified
NJG19637Medicare UPIN